The evaluation uses a cluster-randomized design where 20 geographic clusters (subdistricts) were randomized to allocate them to comparison area, MNP-only area, Behavior Change Communication (BCC)-only area and MNP+BCC areas. The design uses a repeated cross-sectional design, where a community-based random sample of children 6-59.9 months old was surveyed at baseline (April-June 2010). Children 6.23.9 months of age will be surveyed at endline for the MNP intervention in April-June 2013 and for the MNP + BCC intervention in April-June 2014. The impact evaluation design enables the following comparisons: 1) double-difference intent-to-treat estimates of public health impact on anemia, iron deficiency and vitamin A deficiency among the population of children 6-11.9 months of age; 2) end-line only intent-to-treat comparisons of children in each of the intervention arms with the comparison arm; 3) additional analyses of impact on the treated, by levels of exposure, among the MNP arms. Stunting will be assessed using before-after intervention-comparison group differences between 2010 and 2014. Infant feeding practices will be assessed using before-after intervention-comparison area group differences between 2010, and 2013 and 2014.

In addition, the investigators will evaluate the processes through which the BCC and MNP programs roll out using a mix of qualitative and quantitative research methods. Qualitative research methods will help to understand drivers of promotion and sales of MNPs by frontline health workers, as well as household level determinants and dynamics related to enabling purchase and use of the MNP and adhering to behavioral recommendations. Quantitative surveys of frontline health workers will help document their awareness about IYCF, MNPs, training, and sales, while quantitative surveys of the households will help document household level awareness, purchase and use of MNPs and awareness and adherence to IYCF practices for children in the target age range.

1) Impact Evaluation of Behavior Change Communication and Micronutrient Supplementation Interventions on Infant and Young Child Feeding (IYCF) Practices and on Childhood Stunting and Anaemia 2) Evaluation of the Public Health Impact of a Market-based Approach to Improving Diet Quality of Infants and Young Children Through the Use of Sprinkles in Bangladesh

This arm is the basic comparison arm, which will receive the standard package of health services offered through BRAC's essential health care (basic antenatal care, basic counseling on health and nutrition through health worker home visits. In addition, a nationwide mass media campaign on IYCF practices will ensure exposure to some messages about IYCF behaviors in this arm.

Behavioral: Mass media

A nationwide mass media campaign of TV and radio spots on infant and young child feeding practices will be aired in 2011, 2012 and 2013. All intervention arms will be exposed to this campaign.

Experimental: EHC + Micronutrient Powders

This arm will be based on the EHC platform but will also include EHC platform health workers promoting and selling the micronutrient powders.

Dietary Supplement: Micronutrient powders

In this intervention arm, frontline health workers will visit households and promote and sell micronutrient powders to them. The micronutrient powder is sold by the brand name "Pushtikona" in Bangladesh and contains 15 micronutrients including iron, zinc, vitamin A, vitamin C, and others.

Behavioral: Mass media

A nationwide mass media campaign of TV and radio spots on infant and young child feeding practices will be aired in 2011, 2012 and 2013. All intervention arms will be exposed to this campaign.

Experimental: EHC + BCC

This arm will have a behavior chance communications intervention to improve infant and young child feeding practices. The intervention will be delivered primarily by the frontline health workers who will visit mothers in their homes and counsel them on essential IYCF practices.

Behavioral: EHC + BCC

This arm includes home visits to mothers with infants and young children. Frontline health workers will counsel and support mothers in relation to breastfeeding and complementary feeding practices

Behavioral: Mass media

A nationwide mass media campaign of TV and radio spots on infant and young child feeding practices will be aired in 2011, 2012 and 2013. All intervention arms will be exposed to this campaign.

Experimental: EHC + BCC + Micronutrient powders

This arm will contain both the behavior change communication and the micronutrient powder sales intervention.

Behavioral: EHC + BCC

This arm includes home visits to mothers with infants and young children. Frontline health workers will counsel and support mothers in relation to breastfeeding and complementary feeding practices

Dietary Supplement: Micronutrient powders

In this intervention arm, frontline health workers will visit households and promote and sell micronutrient powders to them. The micronutrient powder is sold by the brand name "Pushtikona" in Bangladesh and contains 15 micronutrients including iron, zinc, vitamin A, vitamin C, and others.

Behavioral: Mass media

A nationwide mass media campaign of TV and radio spots on infant and young child feeding practices will be aired in 2011, 2012 and 2013. All intervention arms will be exposed to this campaign.

Eligibility

Ages Eligible for Study:

up to 60 Months

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

Yes

Criteria

Inclusion Criteria:

Child age < 60 months

Contacts and Locations

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To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01678716